Newborn Nursery & Level 2 Neonatal ICU (NICU)

2009 Nurse of the Year

Nursery Clinical REWARDS Recipients for 2008
Dawn Jarman
Lucille Knight

Nursery Clinical REWARDS Recipient for 2009
Christina Barton

NICU Clinical REWARDS Recipient for 2009
Leann McFadden

Location:

The Neonatal Intensive Care Unit (NICU), Intermediate and Well Baby Nursery are located on the second floor of the Regency Medical Center. This unit is accessed through three card swipe access doors and is otherwise isolated from general hospital traffic.

# Beds:

This area accommodates 11 infants requiring Level II NICU services and 20 intermediate/well baby newborns.

Unit Manager:

Tracy Ayers, RN, BSN

Asst. UM:

Donna Shenefield, RNC, BSN

Clinical Educator:

Donna Shenefield, RNC, BSN

Type of unit:

Neonatal Intensive Care Unit (NICU), Intermediate and Well Baby Nursery. Average 2000 deliveries per year.

Typical Staffing:

The staffing pattern is based on acuity and census. Care in the Nursery/NICU is based on Winter Haven Hospital’s Professional Model of Care. All care is patient-centered which incorporates healthcare benchmark staffing parameters to ensure that staffing is consistent with standards used within the industry. Patient care is provided by RNs, Nursing Techs, and students during clinical rotations. Nurse to patient ratio varies according to the acuity.

Typical Patient Diagnosis:

• Three Levels of Care are provided in the Unit: Well Baby, Intermediate and Level II NICU. Infants less than 1000 grams birth weight and infants with conditions requiring surgery, ECMO, high frequency or oscillating ventilation, dialysis or any sub-specialty care unavailable at RMC are transferred to a Level III NICU.
• The majority of infants admitted to the Well Baby Nursery are newly delivered and require support through their transition to extrauterine life. Most infants transition without difficulty, but complications may include hypoglycemia, hyperbilirubinemia, feeding difficulties, hypothermia, and respiratory distress. Infants are transferred to Intermediate care from the Well Baby Nursery when they develop complications during their transition. NICU infants transfer to Intermediate care when their medical condition improves and they require a less intensive level of care.
• Infants admitted to Level II NICU may experience a number of conditions: congenital anomalies, respiratory distress/failure, sepsis, hypoglycemia, hypothermia, persistent pulmonary hypertension, hypotension, prematurity, etc.

An interdisciplinary approach to care of high risk, ill and well neonates is utilized. Nursing staff support nutritional, thermoregulatory and respiratory needs while maintaining cardiac and renal function and protecting the infant from infection, complications, injury, and pain. Emotional and physical and developmental needs are managed with emphasis on the proper amount and type of stimulation. Qualified staff participates in inter-institutional transport of neonates and collaborate with obstetrical staff in the delivery room to provide care for all high-risk newborns. Any infant leaving the Nursery for procedures or testing is accompanied by a RN and/or Respiratory therapist. The parent’s needs for coping and caring for their infant are a primary concern. Discharge planning includes individualized in depth education with rooming-in for high risk infants as appropriate.

Common skills utilized:

Registered Nurses assess the infant’s transition to extrauterine life, diagnose nursing needs, identify achievable outcomes, plan care, implement the plan of care and evaluate the patient’s response to the care. The RN staff coordinates care activities directly, occasionally delegating care to LPNs and Nurse Techs. Services are provided 24 hours per day, 7 days a week and include, but are not limited to:
• Assessing and monitoring infants throughout their transition to extrauterine life including blood sugar and hemodynamic monitoring when appropriate
• Providing comfort including pain management
• Providing instruction to caregivers regarding infant care and safety
• Providing emotional support and guidance for family members
• Respecting the infant’s right to privacy and confidentiality of the family
• Respecting the infant’s and family’s rights and choices including ethical issues
• Promoting family involvement in the infant’s care and decision making
• Providing discharge planning
• Providing therapeutic interventions such as medication administration and respiratory support, as well as management of hyperbilirubinemia, fluids, electrolytes, TPN, hypoglycemia, hypothermia and cardiovascular support.
• Infants are from all socioeconomic levels and from diverse cultural and ethnic origins.

Most common meds / those nurses must be familiar with:

Antibiotics, Dopamine, Caffeine, Lasix, TPN, Lipids, Fentanyl, Vitamin K and Erythromycin.

Care extenders used:

Patient care needs are assessed with input of an interdisciplinary team of nurses, physicians, social workers, respiratory therapists, occupational & speech therapists and education specialists, as needed.

Certification for Differential:

Neonatal Intensive Care Nursing Certification or Low Risk Neonatal Nursing Certification through NCC.

Selling points for Unit:

Experienced and diverse leadership, experienced and knowledgeable staff, cohesive interdisciplinary team, full time medical director, low staff turnover rate, financial assistance for educational development, participation in shared governance, and main focus is patient and staff safety and satisfaction.

More about the Nursery/NICU

More about How we use data for Excellence!

RMC Receives Premier Award!

Our 20th Anniversary!